Browsing by Subject "Adolescent"
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Item Associations between food-related parenting practices and adolescent weight status and disordered eating behaviors: findings from a population-based study(2013-04) Loth, Katie AnnObjectives and Aims: The objective of this dissertation is to explore the types of food-related parenting practices utilized by a racially/ethnically and socioeconomically diverse population of parent-adolescent pairs and to assess the relationship between food-related parenting practices and adolescent weight status and disordered eating behaviors. Background: There is a growing body of evidence that the family environment plays an integral role in contributing to child weight status and disordered eating behaviors, including dieting, unhealthy and extreme weight control behaviors, and binge eating. Specifically, food-related parenting practices have been identified as a potentially significant correlate of weight status and weight-related behaviors among young children. However, unaddressed questions and inconsistencies in the literature both limit the generalizability of preliminary research findings and call into question exactly what food-related parenting practices parents should employ to best support a healthy weight and healthful weight-related behaviors in their adolescent children who are in the process of becoming more independent in making choices related to food and eating. This dissertation fills an important gap in the current literature by broadening the fields understanding of the association between food-related parenting practices and child weight-related outcomes to include an understanding of the nature of this relationship within an adolescent population and among racially/ethnically and socioeconomically diverse parent-adolescent dyads of different genders. The types of feeding strategies utilized within certain population-level subgroups were also examined. Methods: Data for this dissertation were drawn from two coordinated, population-based studies. EAT 2010 (Eating and Activity in Teens) was a population-based study of 2,793 [14.4 years old (SD= 2.0)] adolescents from 20 urban public schools in Minnesota designed to examine dietary intake, weight status and associated factors. Surveys and anthropometric measures were completed by adolescents during 2009-2010. Project F-EAT (Families and Eating and Activity Among Teens) was designed to examine factors within the family environment of potential relevance to adolescent weight-related behaviors. Survey data were collected via mail or phone from up to two parents (n=3,709) of the adolescents in EAT 2010; all parents in Project EAT 2010 were invited to participate in Project F-EAT and a response rate of 77.6% was achieved. Separate linear regression models were fit to estimate the associations between parental report of pressure-to-eat and food restriction and 1) parental demographic characteristics; and 2) adolescent weight status. Adjusted means, difference in means, and 95% confidence intervals were calculated. Poisson regression models were fit to estimate the association between parental pressure-to-eat and food restriction and adolescent disordered eating behaviors (e.g., dieting, unhealthy and extreme weight control behaviors, and binge eating). Prevalence ratios (PRs) and 95% confidence intervals were calculated. To assess potential effect measure modification of the relationship between food-related parenting practices and adolescent weight and disordered eating behaviors by race/ethnicity or income, interaction terms were included in the models. Further, because of our interest in examining the role of gender in the association between food-related parenting practices and adolescent disordered eating behaviors, all analyses were stratified by parent and adolescent gender; potential effect modification by parent and adolescent gender was also examined. In order to account for potential clustering of parent responses when two parents of the same child responded to the survey, a robust variance estimator was used to correct for within cluster variance in all models. Results: Associations with demographic characteristics. The mean level of overall parental food restriction was 2.51 [(scale range: 1 (low control) to 4 (high control)] indicating that, on average, parents within the sample reported engaging in a moderate level of overall food restriction with their adolescent children. Level of restrictive feeding was found to differ significantly by both race/ethnicity and household income, after adjustment for other sociodemographic characteristics, with parents in racial/ethnic minority subgroups and parents with a low household income utilizing the highest levels of food restriction. No significant differences were seen in parent self-report of restrictive feeding practices by parent gender, education level or employment status. The mean level of overall pressure-to-eat reported by parents was 2.21 indicating that on average, parents within the sample reported using a low-to-moderate level of pressure-to-eat with their adolescent child. Parental report of pressure-to-eat feeding strategies varied significantly by parent gender, race/ethnicity, education level and employment status and household income. Fathers reported significantly higher levels of pressure-to-eat than mothers. Non-white parents utilized significantly higher levels of pressure-to-eat compared to white parents. A significant decreasing trend was found between level of parental education and use of pressure-to-eat strategies with parents reporting at least some college education reporting the lowest use of this strategy. No significant differences were seen in parent self-report of pressure-to-eat feeding practices by employment status. Associations with adolescent weight status. Mean food restriction levels were significantly higher among parents of overweight and obese adolescents as compared to non-overweight adolescents. On the other hand, levels of pressure-to-eat were significantly higher among parents of non-overweight adolescents. Fathers were more likely than mothers to engage in pressure-to-eat behaviors and boys were more likely than girls to be on the receiving end of parental pressure-to-eat. Parental report of restriction did not differ significantly by parent or adolescent gender. No significant interactions by race/ethnicity or socioeconomic status were seen in the relationship between restriction or pressure-to-eat and adolescent weight status. This finding suggests that while the extent to which parents adopt a controlling approach to child feeding is known to differ across families,1–4 specifically with regard to race/ethnicity or SES, the associations between food-related parenting practices and child weight status in the current population did not differ based on the race/ethnicity or SES of the parent. Associations with adolescent disordered eating behaviors. Adolescent boys exposed to higher levels of pressure-to-eat or food restriction were significantly more likely to report engaging in dieting and disordered eating behaviors compared to boys exposed to lower levels of pressure-to-eat or food restriction. For example, for every one unit increase in food restriction reported by mothers, boys were two times more likely to engage in extreme weight control behaviors. Examination of the association between food-related parenting practices and dieting and disordered eating behaviors among girls yielded primarily null findings. However, analyses did reveal that for every one unit increase in food restriction reported by mothers, girls were at 1.34 times more likely to engage in extreme weight control behaviors. No significant interactions by race/ethnicity or socioeconomic status were seen in the relationship between food restriction and pressure-to-eat and adolescent disordered eating behaviors. Conclusions: This dissertation added depth to a growing body of scientific literature by being the first research study to explore the specific types of food-related parenting practices utilized by parents of adolescents, as well as the first study to explore associations between food-related parenting practices and adolescent weight status and endorsement of disordered eating behaviors. Findings indicate that use of controlling food-related parenting practices, such as pressuring children to eat and restricting children‟s intake, is common among parents of adolescents, particularly among parents in racial/ethnic minority subgroups, parents with less than a high school education, and parents with a low household income. Further, findings suggest that use of controlling practices is associated with higher weight status among adolescent girls and boys and greater risk of disordered eating behaviors among adolescent boys. Replication studies are needed to confirm these in other adolescent populations. Nonetheless, dietitians, physicians and other health care providers should take time to explore the types of food-related parenting practices utilized within the home and should educate parents on the role that their feeding practices may have in their adolescent‟s weight status and attitude toward food and eating. Clinicians should empower parents to promote a healthy weight and a healthy relationship with food for their teen by making nutritious food items readily available within their home, modeling healthy food choices, and encouraging adolescent‟s autonomy in self-regulation of food intake. Additional qualitative and pilot studies are needed to better understand how to best conduct public health interventions aimed at changing food-related parenting practices. More research is also required to understand parental motivation for use of particular food-related parenting practices and to establish temporality of the observed associations.Item Behavioral therapy to treat functional abdominal pain in children(2012-07-23) Ng, GinaItem Coaching for character: mechanisms of influence on adolescent athletes‟ sportsmanship.(2010-08) Bolter, Nicole D.Extensive knowledge exists about how coaches influence youth sport participants' skill development and motivational outcomes, yet less is known about promoting sportsmanship (Horn, 2008; M. R. Weiss, Smith, & Stuntz, 2008). The purpose of the present studies was to identify mechanisms by which coaches make an impact on youths' sportsmanship. It was first necessary to create a comprehensive measure of coaching behaviors that captures the ways in which coaches influence athletes' sportsmanship. With such a measure, it was possible to examine relationships between coaches' behaviors and sportsmanship outcomes consistent with moral development theory. Study 1 included a series of steps to develop the measure: (a) completing a literature review, (b) conducting focus groups, (c) enlisting an expert panel, and (d) conducting a pilot study. These steps resulted in a 40-item measure reflecting 8 coaching behaviors: (a) Sets Expectations for Good Sportsmanship, (b) Reinforces Good Sportsmanship, (c) Punishes Poor Sportsmanship, (d) Discusses Good Sportsmanship, (e) Teaches Good Sportsmanship, (f) Models Good Sportsmanship, (g) Models Poor Sportsmanship, and (h) Prioritizes Winning Over Good Sportsmanship. Results from Study 1 provided content validity for the Sportsmanship Coaching Behaviors Scale (SCBS). Study 2 was designed to provide further construct validity for the SCBS. The sample included 418 youth (211 females, 207 males), ages 13-18, participating in a variety of team sports (e.g., rugby, lacrosse, basketball, soccer). Participants completed the SCBS and a measure of prosocial and antisocial behaviors toward teammates and opponents. A confirmatory factor analysis established factorial validity for a 6-factor model for the SCBS. Tests for gender invariance showed the 6-factor model to be equivalent for male and female athletes. Criterion validity was shown in that four coaching behaviors (modeling, reinforcing, teaching, and prioritizing winning) were related to athletes' prosocial and antisocial behaviors in theoretically consistent ways. Unique findings emerged for boys and girls in the pattern of relationships between coaching behaviors and sportsmanship outcomes. Collectively, results support and extend moral development theory and research by identifying the specific mechanisms by which coaches promote sportsmanship and by creating a valid and reliable measure of coaching behaviors that can be used in future investigations.Item Development of the adolescent exploratory and risk behavior rating scale.(2009-07) Skaar, Nicole ReneeAdolescence is a time when risk behaviors begin to increase through experimentation with health risk behaviors such as substance used and reckless driving and exploratory risk behaviors such as asking someone on a date and standing up to peers. It is likely that some risk-taking is necessary in the course of social and academic development throughout childhood and adolescence. A shift in the adolescent risk behavior research from a focus on health related behaviors to physical and psychological well-being with a link to educational attainment has gained strength, but the goals of this movement are incomplete. Research is needed to better understand the positive outcomes of health risk and exploratory risk behaviors, and a measure that includes both exploratory risk behavior and health risk behavior is needed. The Adolescent Exploratory and Risk Behavior Rating Scale (AERRS) was developed to address this need. The AERRS was developed using both classical test theory and item response theory methods. The participants were 682 high school students in the Midwest. The results suggest that the developed measure has adequate reliability. The initial examination of validity resulted in a factor structure in which health risk behaviors and exploratory risk behaviors fall into separate factors with some gender differences noted. The item response theory results suggest that risk behavior is a spectrum of behaviors with exploratory behaviors falling on one end and health risk behavior on the opposite end of the spectrum. It was concluded that the AERRS is a reliable measure that has the potential to become a key assessment that has many potential uses in both academic research and applied settings, such as schools.Item Family conflict: the adolescent experience of parent-adolescent conflict and argument.(2012-01) Buzzetta, Chris AnthonyThis study explored the embodied teen experience of parent-teen conflict and argument. Using a hermeneutic-phenomenological approach, data were collected from eight teens living within 150 miles of Minneapolis, MN. Teens self-identified as (a) living in a family with everyday conflict, (b) not seeing a psychologist or counselor, (c) not having been in any drug or alcohol treatment programs, (d) not knowing the researcher ahead of time, and (e) being between the ages of 13 to 19 at the time the interview took place. The interview data were unstructured conversations with teens that were audio-recorded, transcribed, and analyzed using a phenomenological text analysis procedure. From these data, the following themes emerged: (a) feeling powerless, small, devalued, and oppressed; (b) experiencing irritation, frustration, hypocrisy, pettiness, and defiance; (c) wanting freedom and autonomy and the battle for control; and (d) needing safe space and "me" time. Each theme and the whole embodied essence of this experience were interpreted through teens' as well as the researcher's lenses. The interpretations provide insight for teens, parents, and parent educators that may help improve parent-teen relationships and provide strategies to use in the classroom setting.Item The family environment and adolescent girls’ weight and weight-related behaviors: implications for obesity prevention programs.(2010-05) Bauer, Katherine WerdannIntroduction: Over one-third of adolescent girls in the United States are overweight or obese, and most are not regularly physically activity (PA), watch excessive television (TV), frequently consume soft drinks, and consume an insufficient amount of fruits and vegetables (FV). Although studies have observed associations between factors in the family environment and youths' participation in these behaviors, questions remain as to how families can best help their adolescent daughters achieve and maintain a healthy weight. Additionally, while school-based obesity prevention interventions offer great potential to help youth modify their behavior and weight, it is unknown whether adolescents can make meaningful improvements without support and resources from their families. Utilizing data from New Moves, a school-based physical activity and nutrition intervention, this dissertation aims to 1) explore sociodemographic differences in girls' weight-related family environments, 2) test cross-sectional associations between family environment factors and girls' total PA, moderate-to-vigorous PA, TV use, soft drink intake, FV intake, body mass index (BMI), and body composition, and 3) determine whether factors in girls' family environments are associated with girls' improvements in behavior, BMI, and body composition over the course of New Moves, as well as whether factors in the family environment modify the effect of New Moves. Method: Subjects included 253 adolescent girls from 12 schools who participated in New Moves (mean age = 15.7) and one of their parents. At baseline, parents completed surveys assessing the family environment. At baseline and post-intervention 9-12 months later, girls' PA and TV use were measured by a 3-Day Physical Activity Recall (3DPAR) and dietary intake by survey measures. Height and weight were measured by study staff and body fat was measured using dual-energy X-ray absorptiometry (DXA). Hierarchical linear and logistic regression models were used to address study aims. Results: Girls' family environments differed in many ways by girls' race/ethnicity, foreign-born status, and parental education. These differences frequently reflected the disparities in weight and weight-related behavior observed among adolescent girls in other study populations. Several cross-sectional associations were observed between family environment factors and girls' behavior and weight. Parental modeling of eating and physical activity consistently predicted girls' behavior, home food availability was positively associated with girls' intake of soft drinks and FV, and more frequent family meals were associated with greater FV intake. In contrast, few relationships were observed between the family environment and girls' odds of successful behavior, BMI, and/or body composition change over the course of New Moves. However, the pattern of significant associations suggests that girls from less supportive family environments were more likely to successfully modify their behavior, BMI, and body composition. For example, girls from families that provided more support for PA had a lower odds of increasing their PA (OR=.62, p=.04), girls who had high home soft drink availability had a greater odds of decreasing their soft drink intake (OR=1.99, p<.01), girls with more TVs at home had a greater odds of decreasing their BMI (OR=1.65, p=.04), and girls with more media resources at home had a greater odds of decreasing their body fat (OR=1.87, p=.03). None of the family environment factors examined modified the effect of New Moves on girls' behavior or body composition. However, the number of TVs in girls' homes served as a modifier of the effect of New Moves on girls' BMI with no intervention effect seen among girls with 3 or fewer TVs, while girls in the intervention condition with 4 or more TVs at home had a lower baseline-adjusted BMI post-intervention as compared to girls in the control condition with 4 or more TVs at home. Conclusions: This dissertation provides additional support for the role of the family environment in youths' weight-related behaviors, weight, and body composition. While girls with less supportive family environments were at greater risk for being physically inactive, having poor dietary intake, and being overweight or obese, few associations were observed between girls' family environments and improvement of their weight-related behavior, BMI, and body composition during the course of a school-based intervention. These findings suggest that school-based interventions offer an opportunity to decrease the risk of obesity among all adolescent girls, especially those who receive less support and resources for healthful behavior from their families.Item An fMRI study of emotional face processing in adolescent major depression(2013-02) Jappe, Leah MarieOBJECTIVE: Major Depressive Disorder (MDD) is a serious, often chronic illness associated with significant impairment and suicide. MDD often begins during adolescence when brain areas that regulate emotion processing are still maturing. To expand upon our limited understanding of the neurobiological underpinnings of MDD early on in development, this study examined function within fronto-limbic neural circuits in response to an emotional faces task among depressed adolescents and healthy controls (HC) using functional magnetic resonance imaging (fMRI). METHOD: 34 adolescents with MDD (12 medicated, 22 unmedicated) and 16 healthy age and gender matched controls completed an emotional faces task where BOLD response was examined when viewing happy and fearful faces (presented in a block design) during fMRI. Scanning was completed using a 3.0 Tesla scanner. Data preprocessing and analysis was carried out using FEAT in FSL. Whole brain group level analyses were conducted using a mixed-effects model (FLAME) with cluster-wise significant testing (min Z=2.32; cluster significance = p<0.05, corrected). RESULTS: In response to viewing fearful versus happy faces, MDD showed reduced activation in areas of the right thalamus, right insula, and right hippocampus compared to HC. CONCLUSION: Results suggest that emotion processing in adolescent MDD is associated with abnormalities in subcortical and paralimbic brain regions within the broader fronto-limbic neural network. It is possible that these findings reflect deficits in depressed adolescents' ability to elicit cognitive control from higher cortical regions and to accurately respond to and process the emotional significance of fearful stimuli.Item From the silver screen to teens: describing the prevalence of smoking in movies as perceived by teenagers and exploring the underlying mechanism of the association bewteen smoking in movies and adolescent smoking: a longitudinal analysis.(2010-08) Choi, Tsz Chun KelvinSmoking in movies has been repeatedly shown to be associated with adolescent smoking. However, previous reports on the association were limited to exposure to top-grossing contemporary movies, and did not assess changes in the exposure over time. These reports were also restricted to exposure during early adolescence (ages 9-15), and focused mainly on initiation of smoking. While they have hypothesized mediators that could potentially explained the association, they did not use a longitudinal study design to assess the abilities of these mediators to explain the association. Using data from the Minnesota Adolescent Community Cohort (n=4735), a prospective observational cohort study with six age cohorts (age cohort 11, 12, 13, 14, 15, and 16), we examined changes in the prevalence of smoking in movies as perceived by teenagers over time. We observed a decline in the perceived prevalence of smoking in movies in all age cohorts, and the decline was steeper in the three older age cohorts than the three younger age cohorts (p<0.05). However, teenagers were still estimated to be exposed to these depictions some of the time at the end of the observation period. We also assessed the effect of changes in the perceived prevalence of smoking in movies on progression of smoking intensity from age 12.5 to 17.9, and found that the perceived prevalence of smoking in movies consistently predicted smoking intensity measured six months later (p<0.05), but only during younger adolescence (exposure from age 13-15.4). In the longitudinal mediation analysis, with data collected when the participants were ages 12-15.9 (n=3112), we found that the perceived prevalence of adult smoking explained an insignificant portion of the association, while the positive expectancies of smoking did not satisfy the criteria for a mediator. Although the amount of smoking in movies has declined, teenagers were still exposed to a moderate amount of these images, which could intensify their smoking behavior, particular when exposed as young adolescents. Further studies are needed to examine other potential mediators to guide the development of interventions to alleviate the negative influence of these images on teenagers.Item Identity profiles and psychological adjustment among adopted Korean American adolescents(2012-08) Reichwald, Reed TylerDrawing upon social identity and intersectionality theories and research, I conducted a person-centered, multi-informant study of 158 pairs of adopted Korean American adolescents (AKAA) and their adoptive parents. Using cluster analytic procedures, I examined AKAA' patterns of identification across multiple social domains (ethnic, racial, and adoptive identities). The obtained clusters were validated empirically by comparing groups along relevant variables (e.g., engagement in ethnic and racial socialization, dissatisfaction with racial appearance, birth family interest, perceived discrimination, colorblind attitudes, diversity in friendship networks) on which they would be expected to differ . Finally, I examined the association between these identity profiles and psychological adjustment, including behavioral development and other measures of well-being. Results revealed the emergence of six conceptually unique identity clusters that differed significantly on the various validity constructs measured. However, the identity profiles were largely undifferentiated with respect to behavioral development per parent and adolescent reports on the Strengths and Difficulties Questionnaire (SDQ, Goodman, 1997). Group differences were found on broad psychological outcomes including life satisfaction, perceived school belongingness and peer competence, and school interest and motivation. Results confirm the importance of considering the collective impact of multiple social identities on a variety of outcomes.Item Interview codings of attachment style:using profile analysis to understand the patterns involved.(2011-01) Swinburne Romine, Rebecca EstherAttachment style is frequently discussed in terms of profiles of early childhood risk factors. Those using attachment interview methods use their ratings of these risk factors in developing an attachment style rating. In spite of this, profile analysis has yet to be used to model specific attachment styles. By using a multiple regression profile analysis to model attachment style in terms of coder's ratings of early risk factors, we can test empirically whether individual elements are relevant and how. The study of attachments began with Freud in the middle of the last century. Since that time attachment style has been studied first by John Bowlby and Mary Ainsworth, and since that time by many others. Early views of attachment, including the identification of specific attachment styles, and the investigation of its stability are discussed, as well as the limitations of the existing research. Specifically, the paper addresses the need for additional research to support or refute the theoretical models of attachment structure. Many methods have been developed to assess attachment style, most of which are closely tied to one particular theoretical view of attachment structure. Because the data for this paper are drawn from a study which utilized a four-prototype model of attachment as assessed for a coded semi-structured interview, the best way to understand the resultant codes is through a profile analysis. By using a two-step multiple regression profile analysis procedure, we can assess the unique contributions of both the level of risk, and the pattern of risk factors. The multiple regression methodology has the additional benefit of allowing for both continuous predictors and criterion variables; something that is not possible with other profile analysis methodologies. This allowed me to run the regressions with both dichotomous and semi-continuous criterion variables which enable the detection of different patterns. The results indicate that both the profile patterns and level can predict the criteria. The pattern component however is significantly more predictive of the criteria. While the derived patterns differ from the predicted patterns, they remain consistent with theory. Overall, environmental risk factors such as abuse, neglect, and parental rejection were not predictive of attachment style or score, while individual risk factors such as anger at parents and rebellion, and the interactive factor of role reversal were highly predictive. This leads us to conclude that profiles are a viable method of understanding attachment styles, and that it is the individual's responses to the risk factors present in the childhood environment rather than those factors themselves which determine attachment style.Item The lived experience of Type 2 diabetes in urban-based American Indian adolescents.(2011-05) Martin, Lisa C.This qualitative nursing research study used a hermeneutic phenomenological perspective to discover meaning in urban-based American Indian adolescents' experiences living with Type 2 diabetes. The aim of this study was to understand what it meant for urban-based American Indian adolescents to live with and experience Type 2 diabetes. The study used phenomenologic unstructured interviews to describe and represent the adolescent's voice and experiences of living with the disease in an urban community. The study was guided by Max Van Manen's methodology for phenomenological research. This method entailed turning to the phenomenon of interest, then, inquiring and investigating the experience as it was lived rather than as it was conceptualized. The study reflected and analyzed essential themes that characterized the phenomenon of living with Type 2 diabetes and presented the phenomenon through the art of writing and re-writing. Data collection involved in-depth, in-person interviews with analysis of the resulting transcripts. Adolescents in this study described connections with the American Indian culture, past and present family members, and the pragmatic details of living each day with the disease. Essential themes of the adolescents' experiences were found in the lifeworld areas of relationality and temporality, followed by incidental themes in the areas of corporeality and spatiality. The study findings illuminated the participants' personal meanings and validated the phenomenological research process. A preliminary conceptual model based on the lifeworld categories for understanding adolescents' experiences was proposed and had implications for education, research, and practice, supporting continued inquiry.Item Measuring psychopathy traits and antisocial behaviors in three groups of male adolescent sex offenders and male non-sexual delinquents.(2010-11) Netland, Jason DavidThe main goal of this study was to determine if there are differences in four groups of male adolescents (i.e. child sex offenders, peer/adult sex offenders, crossover sex offenders, and non-sex delinquents) in their levels of psychopathy traits (i.e. grandiosity, impulsivity, lack of empathy, interpersonally exploitative, and risk taking) and antisocial behaviors. The non-sex delinquents group was found to have significantly higher levels of grandiosity and lack of empathy than the three sex offender groups. The three sex offender groups were found to have significantly higher levels of antisocial behavior than the non-sex delinquent group. A confirmatory factor analysis using the Multidimensional Inventory of Development, Sex and Aggression (MIDSA; MIDSA Clinical Manual, 2007) scales for psychopathy traits and institutional record review measures of antisocial behavior provided no evidence for adequate fit for the two, three, or four-latent factor models of psychopathy.Item Mothers' and adolescent daughters' perceptions of communication about sex.(2008-06) Kody, Carli Alanna BraunDrawing upon Consensual Qualitative Research methods (CQR; Hill, Thompson, & Williams, 1997), this qualitative study examined mothers' and adolescent daughters' perceptions of their communication about sex. Fifteen Mother and daughter dyads ( n = 15 mothers, n = 15 daughters) from a major Midwestern metropolitan area participated in individual, semi-structured interviews. Interviews were audio-recorded and later transcribed. Transcriptions were manually analyzed using CQR techniques to extract major domains and categories. Domains and categories were compared between mother-daughter dyads and across mothers and daughters using cross-case analysis procedures. Data analysis and consensus procedures yielded 17 domains and 55 categories for mothers and 15 domains and 44 categories for daughters. Findings revealed that mothers and daughters perceived mother-daughter communication about sex as more complex than their communication about other topics. Mothers and daughters described little or no discussion about intimacy and/or pleasure as it relates to sex and sexuality. Furthermore, they described discomfort (e.g., vulnerability, awkwardness, uncertainty) related to discussing sex, feelings that are unique to this topic (at least with respect to their frequency and intensity). Mother and daughters struggled with self-disclosure boundaries. They worried about each other's reactions and the consequences of what they expressed during discussions about sex-related topics. Mothers expressed ambivalence, for instance, wishing to talk with their daughters about sex, but not wanting them to actually know about sex. Overall, mothers and daughters wished to improve their communication about sex. Although mothers and daughters seemed to share similar perspectives on the process of their mother-daughter communication about sex, they appeared to disagree on the content of their communication. Consistent with prior research, overall level of dyadic agreement was low. Major findings are discussed and practice implications and research recommendations are presented.Item Online book clubs for the net generation.(2009-07) Scharber Doering, Cassandra M.This dissertation examined online book clubs for youth offered during the summer by a metropolitan public library system. Voluntary reading rates for both boys and girls plummet as they move through adolescence (NEA, 2007, NAEP, 2005). Book clubs are one way to support youth in pleasure reading (Appleman, 2006). Although many book clubs geared for youth are school-based, researchers are beginning to take notice of the possibilities that exist for literacy and learning outside the classroom (Hull & Schultz, 2001). These online book clubs were viewed as sites of possibility -- lenses through which both schools and libraries can more readily understand the possibilities that exist in encouraging "old" and "new" literate practices (Lankshear & Knobel, 2005). This case study utilized Computer-Mediated Discourse Analysis (Herring, 2006) and Critical Discourse Analysis (Fairclough, 1995) to understand more deeply the practices and discourses employed within these online book clubs. Three book clubs (one all-boy, one all-girl, and one mixed-gender) were investigated to understand (1) who participated in these clubs, (2) how both preteens and facilitators participated and (3) the ways in which the online context and gendered separation of the clubs shaped the clubs' discourse. Analysis of these clubs indicated the promise of online book clubs in (1) providing support for continued voluntary reading, (2) engaging non- and/or struggling readers, and (3) offering a safe scaffold for youth to experience and broaden their new literacies skills and practices. In addition, a model that identifies the elements necessary for engaging youth in online book clubs was proposed.Item Paternity and father-offspring relationships in wild chimpanzees, Pan troglodytes schweinfurthii.(2010-03) Wroblewski, Emily ElizabethHamilton's seminal theory of kin selection asserts that because relatives share a certain proportion of genes, individuals can increase their inclusive fitness by helping and/or not harming kin, as long as the benefits to kin outweigh the costs to the individual. We would expect animals to attain maximal inclusive fitness by discriminating both the available maternal and paternal kin from non-kin in their social groups. The primate order is a useful taxon in which to study kin selection and kin discrimination because most primates live in permanent social groups with both kin and non-kin between which to discriminate, and their complex social interactions provide many opportunities to both hurt and aid others. However, the prevailing view has been that the discrimination of paternal kin does not occur in most species. Despite emerging studies that suggest otherwise, study of paternal kin discrimination thus far has been limited in primates. Furthermore, study has been restricted to matrilineal species with male-biased dispersal. Paternal kinship could also be important in a patrilineal species such as chimpanzees as males will remain with fathers and other paternal kin for life, as will females until they disperse. Thus, this study aimed to further our understanding of importance of paternal kinship in social behavior by examining the most direct paternal relationship, that of fathers and offspring, in the chimpanzees of Gombe National Park, Tanzania. Identifying fathers and offspring and characterizing their relationship is a necessary first step on the way to testing for kin discrimination amongst non-descendent paternal kin. Thus, in Chapter 1, I first determined paternal relationships and explored patterns of male reproductive success relative to dominance rank and the priority of access model, as well as fathers' mating strategy and age. Then in Chapter 2, I examined whether fathers showed parental investment in their juvenile and adolescent sons. Finally, in Chapter 3, I investigated whether there was inbreeding avoidance between fathers and daughters.Item Relationship of Apolipoproteins and Subclinical Cardiovascular Risk in Children and Adolescents(2020-05) Czeck, MadelineINTRODUCTION: Apolipoproteins play a role in regulating cholesterol transportation and clearance with each apolipoprotein having a protective or atherogenic role. However, previous literature in youth have insufficiently described the relationship between each apolipoprotein variable and subclinical cardiovascular risk. Hence, the purpose of this study was to examine the association of apolipoproteins with measures of vascular structure and function in children and adolescents. METHODS: A cross-sectional study of 338 youth (160 males, 178 females; mean age = 13.0+/-2.8 years) with a range of adiposities from normal body weight to severe obesity. Apolipoproteins (AI, AII, B100, CII, CIII, and E) were measured via human apolipoprotein magnetic bead panel. Ultrasound imaging of the carotid artery was used to measure carotid intima-media thickness (cIMT), carotid cross-sectional compliance (cCSC), carotid diameter compliance (cDC), carotid cross-sectional distensibility (cCSD), carotid diameter distensibility (cDD), and carotid incremental elastic modulus (cIEM). Applanation tonometry assessed pulse wave velocity (PWV). Dual X-ray absorptiometry measured total body fat percent. Linear regression models were adjusted for Tanner stage, sex, and race with further adjustments for body fat percent. Data are presented as mean [95% CI] with Holm’s-adjusted p-values to account for multiple testing. All apolipoproteins were scaled to 10 ug/mL and apolipoprotein ratios were scaled to 0.1 ug/mL. RESULTS: Prior to accounting for multiple testing, apolipoprotein CIII:CII ratio was positively associated with cIMT (0.001 [0, 0.003], p = 0.033), but failed to maintain significance after p-value correction. Otherwise, there were no significant associations between any apolipoprotein and cIMT, cCSC, cDC, cCSD, cDD, and cIEM in the presence or absence of body fat percent. There were significant positive associations between PWV and apolipoproteins: AII (0.04 m/sec [0.02, 0.06], p = 0.046) and E (0.16 m/sec [0.08, 0.24], p = 0.012). After adding body fat percent to the models, PWV remained positively associated with higher levels of apolipoproteins E (0.16 m/sec [0.08, 0.24], p = 0.01). CONCLUSIONS: These findings suggest higher levels of apolipoprotein E are associated with higher arterial stiffness (PWV) in pediatrics, both in the presence and absence of excess body fat.Item Relationships between Adolescent Stress, Depressive Symptoms, Social Support, Coping and Sexual Risk Behavior in Young Adulthood(2017-01) Ghobadzadeh, MaryamObjective To describe longitudinal associations among adolescent stressful life events, depressive symptoms, coping skills, social support, and young adult sexual risk behaviors and sexually transmitted infection (STI) in the United States. Design A total of 18,924 participants aged from 12 to 18 at baseline were included in the analysis. The study's design was a secondary analysis of three waves of longitudinal data utilized structural equation modeling (SEM) to test direct and indirect effects of adolescent stressful life events, depressive symptoms, problem-focused coping skills, unhealthy coping strategies, and social support on young adult sexual risk behavior. To examine the hypotheses of this study, three main structural models were evaluated. Model 1 explores the effects of depressive symptoms and stressful life events as the potential mediator of the association between mental health problems and sexual risk behavior, while Model 2 tests mediating effect of unhealthy coping strategies. Lastly, Model 3 examines the indirect effects of problem-focused coping skills and social support on sexual risk behavior. Results As anticipated, direct effects were found for adolescent stressful life events and unhealthy coping strategies on young adult sexual risk behavior. Adolescent stressful life events and unhealthy coping also significantly mediated the relationship between depressive symptoms and young adult sexual risk behavior. Higher social support from family and problem-focused coping strategies were associated with lower depressive symptoms and stressful life events in adolescence. Adolescent social support from family and problem-focused coping skills were shown to influence young adult sexual risk behavior indirectly through reducing stressful life events. Conclusions Given the associations between stressful life events, depressive symptoms, and sexual risk behavior, these findings highlight a need for screening for depression and stressful life events in adolescents. Findings may also be useful to inform interventions for high-risk adolescents facing psychological stressors and suggest that coping skills training and enhancing social support should be specific targets.Item “S.P.L.A.S.H. Into Fitness!” An Identity-Focused Behavioral Swim Camp and Family-Oriented eHealth Intervention for Girls(2020-01) Kramer, EydieDespite a recent plateau in the trend, childhood and adolescent overweight and obesity rates remain high in the United States. Furthermore, insufficient physical activity participation and poor dietary habits are common in girls throughout adolescence. Adolescent girls are disproportionately at risk for poor health behaviors and unhealthy weight gain as compared to their male counterparts. Research indicates that summer presents a heightened behavioral risk for girls, as poor dietary habits and physical inactivity increase in these months. A strategy to mitigate this seasonal risk may be to engage girls in summer camps which target healthy nutrition and exercise outcomes, albeit positive lifestyle changes associated with similar behavioral programs have been short-term in nature. Indeed, the behavioral intervention literature is fraught with mixed findings regarding long-term positive results, perhaps due to two factors: 1) previous studies targeting youth have not directly intervened upon identity, an important psychological mechanism which meaningfully influences longitudinal behavior, or 2) intervention designs did not consider the need for family-oriented programming to habituate healthy behaviors in the home environment. An individual strives to remain in behavioral congruence with their chosen identity standards. Thus, physical activity may be influenced by one’s exercise identity and dietary behaviors may be impacted a salient healthy eater identity. Notably, identity is best developed during the adolescent years and trends as stable across the lifespan. Therefore, the development of a girl’s exercise and healthy eater identity through participation in a family-oriented intervention is of interest. However, identity-focused and family-oriented interventions should initially be offered in the summer months as part of a multicomponent framework, to best address behavioral risks which are exacerbated during this time frame. This dissertation investigated the effectiveness of a multicomponent intervention, comprised of a 1-week behavioral camp and a 10-week family-oriented eHealth program, on a variety of health outcomes in pre-adolescent girls when results from the intervention group were compared to a control group. All study participants attended an identity-focused, behavioral swimming and healthy lifestyle camp for one week in the summer, prior to randomization to either access eHealth (intervention group) or to a usual care comparison (control group). Both the camp and eHealth program aimed to develop girls’ exercise identity and healthy eater identity, and subsequently enhance healthy behaviors. It was hypothesized that the camp-plus-eHealth condition (i.e., intervention) would report improved exercise identity, healthy eater identity, and physical activity and dietary behaviors as compared to the camp-only condition (i.e., control) due to the extended availability of intervention materials in the home environment via the eHealth program. This dissertation includes three study manuscripts, entitled as Chapters 4, 5, and 6. Chapter 4 describes the importance of key community stakeholders in the intervention design phase, and additionally offers lessons-learned for future intervention design teams. Chapter 5 provides findings from between- and within-group analytic comparisons of the intervention and control groups and addresses the study’s specific aims, attached hypotheses, and a question of interest concerning participants’ compliance with physical activity guidelines at baseline, post-camp, and follow-up measures. Additional questions of interest were posed, such as: 1) which psychological factor (i.e., exercise identity or healthy eater identity) would be most associated with follow-up physical activity and dietary behaviors, and 2) would eHealth compliance be associated with study outcomes? In-depth answers to these questions of interest are available in Chapter 6 of this dissertation. Chapter 6 also provides qualitative feedback regarding the perceived utility and usability of the intervention eHealth website. Collectively, this dissertation provides unique perspectives regarding a novel behavioral intervention strategy for pre-adolescent girls: target exercise and healthy eater identity development. Findings from the three dissertation manuscripts may be utilized by future public health researchers to provide identity-focused and family-oriented interventions for larger populations of at-risk girls.Item Sleep patterns and risk of injury among rural Minnesota adolescents.(2009-08) Langner, Deborah MerchantSleep occupies a third of our lives; yet, only of late has credit been given to the significant role it plays in our health and well-being. Teens often are limited in the duration of sleep acquired, due to time-consuming activities, as well as biological and environmental aspects of adolescence. The current study explores potential risk of injury among teens by examining associations between sleep patterns, sleep duration, and injury. Youth at Work, an open cohort from 41 rural high schools in Minnesota, followed 15,002 students from 2001-2003. Data were collected through a self-completed questionnaire, distributed to each student four times during the 2001-2002 and 2002-2003 school years. Questionnaire responses described events in either the summer months (fall administration) or the school year (spring administration). A total of 41, 272 questionnaires were completed. Analysis included odds ratios (OR) and 95% confidence intervals (CI) calculations using logistic regression, controlling for potential confounders by means of directed acyclic graphs. Results indicated that adolescents who reported sleeping six hours or less every night during the summer had an increased risk of injury (OR = 1.40; CI = 1.13, 1.72). Risk of injury increased further for individuals who slept six hours or less during the weekend nights in the summer, but received optimal sleep on weeknights (OR = 1.60; CI = 1.20, 2.14). During the school year, students who reported six hours of sleep or less during school nights and sub-optimal sleep on weekend nights also had an increased risk of injury (OR = 1.53; CI = 1.07, 2.20), as did individuals who slept nine hours or longer on weekend nights but acquired insufficient sleep on school nights (OR = 1.71; CI = 1.22, 2.39). Among working adolescents, teens employed in entertainment who routinely slept six hours or less or greater than six hours but less than nine hours, had the greatest risk of work-related injury, compared with well-rested teens in this occupation (OR = 3.61; CI = 1.17, 11.09). Construction workers who slept either insufficient or sub-optimal hours also were nearly three times as likely to be injured as teens sleeping optimal hours (OR = 2.69; CI = 1.19, 6.06). Among farmers, risk of injury doubled for young adults who had insufficient sleep some nights, but slept optimally other nights (OR = 2.05; CI = 1.37, 3.07). Improved knowledge of these associations and potential risks could help to target intervention efforts for the prevention of injuries among adolescents.Item Structural and functional development of the orbitofrontal cortex during adolescence.(2008-08) Hooper, Catalina JaneThis study was designed to assess the structural and functional development of the orbitofrontal cortex (OFC) in healthy adolescents (age 9 to 23, N = 129). Functional integrity was assessed using a probabilistic reversal learning task that is known to depend on the OFC. Repeated measures ANOVAs showed significant differences between age groups until approximately age 12. After age 12, performance leveled off, even on the more difficult probabilistic blocks. When the association between pubertal stage (as determined by self-report questionnaires) and reversal learning performance was examined, pubertal stage was found to be a stronger predictor of performance than age for most reversal learning variables. Pubertal stage also interacted with gender to predict performance on some reversal learning variables. Structural development of the whole brain was assessed using vertex-based analysis of cortical thickness derived from T1-weighted MRI scans and using voxel-based morphometry of fractional anisotropy (FA) derived from diffusion tensor imaging scans. Widespread decreases in cortical thickness and increases in FA were observed during this age range, particularly in association cortex and in major white matter pathways connecting to the frontal, parietal, and temporal lobes. Most associations with age were best fit with a linear model, but there were a few clusters in which quadratic or cubic models improved the fit. Within the age range in which reversal learning performance was developing (9 - 12) there were fewer associations between the brain variables and age than in the older adolescents (13 - 23 years), perhaps due to power limitations in the younger group. Perseverative errors on the reversal learning task were associated with cortical thickness in the superior frontal gyrus and the superior parietal cortex and with FA within anterior corpus callosum, as well as other pathways connecting to the frontal lobe. After controlling for age, only the association between FA and perseverative errors within the anterior corpus callosum remained significant, suggesting that most of the associations were developmental in nature. A gender by pubertal stage interaction was also observed in the relationship between perseverative errors and FA within this region. Results are discussed in relation to adolescent risk-taking behavior.